Adult Diphtheria Vaccination

Low adult vaccination coverage in Indonesia may contribute to a recent outbreak of diphtheria in Indonesia. Although well known as a pediatric vaccine, diphtheria vaccination should be administered as booster to adolescence and adults for longer prevention. Adult vaccine differs from pediatric vaccine but have similar protection. Additionally, there is special recommendation to vaccinate pregnant women and elderly people aged 65 years or more

Food IgE-Sensitization in Respiratory Allergic Patients in Jakarta

Food allergy and respiratory allergy may co-exist in atopic person. Although both conditions can worsen allergic symptoms, food allergen sensitization has not gain much attention in clinical studies. The aim of this study is to evaluate food IgE sensitization in respiratory allergic patients. This was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, on September to December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent test. Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. A total of 100 subjects were eligible for analysis; 76% were women. Patients mean age was 38.8+12.1 (range 19-59) years old; 62% of the patients have both asthma and allergic rhinitis. There are 46% patients with at least one positive food-IgE sensitization. The most common sensitization was to shrimp (17%), followed by fruit-mix (14%), goat milk (13%), crab (13%), potato (13%), soybean (11%), and strawberry (11%). Significant difference of IgE sensitization was found between house dust mites and crab or shrimp and between cockroach and crab or shrimp. In conclusion food-IgE sensitization in respiratory allergic patients is common. The most common allergens were shrimp, fruit-mix, goat milk, crab, and potato.&nbsp

Pollen Serum Specific IgE Sensitization in Respiratory Allergic Patients in Jakarta, Indonesia

Background: pollens from trees or grasses in Indonesia have a perennial distribution due to the tropical climate. However, pollen allergy has not been well studied. This study aimed to evaluate the profile of pollen IgE sensitization in respiratory allergic patients in Jakarta. Methods: this was a cross-sectional study in patients with a history of respiratory allergy in Jakarta, Indonesia between September and December 2016. Adult asthmatic patients aged 19-60 years were invited to undergo serum specific IgE testing at the Allergy and Immunology Clinic, Cipto Mangunkusumo Hospital, Jakarta. Patients were included if they showed at least one positive skin prick test with environmental allergens. Quantitative determination of specific IgE in serum was carried out by multiple allergosorbent (MAST) assays (Polycheck Allergy®, Biocheck GmbH, Munster, Germany).  Serum specific IgE levels of more than 0.35 kU/L or Class 1 was considered positive. Results: a total of 106 cases were eligible for analysis; 81 (76.4%) were women. Patients’ mean age was 38.8+12.1 (range 19-59) years old. 59.4% of patients have both asthma and allergic rhinitis. There are 9 (8.5%) patients positive for IgE-pollen sensitization; 8 among them showed sensitization to at least 2 pollens. Sensitivity to goosefoot pollen is the highest (5.7%), followed by rye pollen (4.7%), plantain pollen (4.7%), wall pellitory pollen (4.7%), and Bermuda grass pollen (3.8%). Conclusion: although most pollens tested are not originated from native plants to Indonesia, a small number of patients showed specific IgE-sensitizations. Allergic persons planning to travel to the endemic areas of the relevant pollen should be advised. A panel of pollen allergens from local plants is highly desired

PENGAWASAN ORANG TUA DALAM INTENSITAS PENGGUNAAN MEDIA SOSIAL TERHADAP PROKRASTINASI AKADEMIK

This research aim is conducted to obtain description about the influence of parental control in the intensity of social media use on academic procrastination. The research was conducted in the SMP Putra 1 Jakarta. The method used in this quantitative assosiatif approach. The population in this research is VII, VII, IX grade students of SMP Putra 1 Jakarta, with the total sample of 83 respondents. Data was taken by using proportionate stratified random sampling. The prerequisite test in this study lilifoers normality test and rgresion linearity test, the result of the test that normal and linear. Result of correlation coefficient test are obtained -0,616 > 0,217. Result of t-test with significant level 0,05 obtained -7,04 > 1,99, it is explained that the are a negative correlation and significant correlation between parental control in the intensity of social media use on academic procrastination. Result of significant regression obtained 30,68 > 3,96, it is explained that there significant influence between parental control in the intensity of social media use on academic procrastination. Parental control in the intensity of social media use on academic procrastination of 37,9%, and the remaining 62,1% is determined by other factors which is not examined. Abstrak Penelitian ini bertujuan untuk memperoleh gambaran tentang pengaruh pengawasan orang tua dalam intensitas penggunaan media sosial terhadap prokrastinasi akademik. Penelitian ini dilaksanakan di SMP Putra 1 Jakarta. Jenis penelitian ini adalah kuantitatif asosiatif. Populasi pada penelitian ini adalah siswa/i SMP Putra 1 Jakarta kelas VII, VIII, dan IX, dengan jumlah sampel sebesar 83 responden. Teknik pengambilan data menggunakan proportionate stratified random sampling. Uji prasyarat pada penelitian ini menggunakan uji normalitas lilifoers dan uji linieritas regresi, diperoleh hasil bahwa data berdistribusi normal dan bersifat linear. Uji hipotesis data yang digunakan adalah korelasi koefisien product moment diperoleh -0,616 > 0,217. Hasil uji t dengan taraf signifikan 0,05 diperoleh 7,04 > 1,99, hal ini menjelaskan bahwa terdapat korelasi negatif dan hubungan yang signifikan antara pengawasan orang tua dalam intensitas penggunaan media sosial terhadap prokrastinasi akademik. Perhitungan uji signifikan regresi diperoleh 30,68 > 3,96, maka terdapat pengaruh yang signifikan antara pengawasan orang tua dalam intensitas penggunaan media sosial terhadap prokrastinasi akademik. Pengawasan orang tua dalam intensitas penggunaan media sosial memberikan sumbangan efektif terhadap prokrastinasi akademik sebesar 37,9%, sedangkan sisanya 62,1% ditentukan faktor lain yang tidak diteliti

The Comparison of Interleukin-17 and Interleukin-10 with Systemic Lupus Erythematosus Disease Activity

AIM: This study was conducted to compare means of interleukin-17 (IL-17) (Th17 cytokines) and interleukin-10 (IL-10) (T-regulatory cytokines) as pro-inflammatory and anti-inflammatory cytokine with disease activity of systemic lupus erythematosus (SLE) and to investigate correlation between IL-17 cytokine serums with IL-10 in SLE patients. METHODS: This study recruited total of 68 SLE patients which included 34 active and 34 inactive patients based on MEX-SLEDAI as disease activity tool measurement and subjects were selected using consecutive sampling method. Blood samples were taken from subjects and IL-17 and IL-10 were measured using ELISA method. Data were analyzed with SPSS 26 software. RESULTS: Mean IL-17 was 19.67 ± 1.299 pg/ml in active SLE group and 19.78 ± 1.187 pg/ml in inactive group. Median of IL-10 in active group was 3.63 pg/ml and in inactive group was 2.52 pg/ml, respectively. No significant mean differences were found of IL-17 and IL-10 between active and inactive SLE patients (p > 0.005). We found significant positive correlation between IL-17 and IL-10 (p < 0.005; r = 0.529). CONCLUSION: There were no significant mean differences of IL-17 and IL-10 between active and inactive SLE patients. However, we found elevated result of IL-10 in active SLE than inactive. There was positive correlation between IL-17 and IL-10

The Balance between Interleukin 5 and Interleukin 10 Level in Persistent Atopic Asthma after House Dust Mite Allergen Dermatophaigoides pteronyssinus (Der p) Stimulation

Asthma is a chronic inflammation of the respiratory tract characterized by coughing, shortness of breath, wheezing and limited expiratory airflow. Interleukin 10 (IL-10) is a cytokine produced by T regulators which functions to suppress pro-inflammatory production and development. Interleukin 5 (IL-5) is glycoprotein produced by Th2 which acts as a proinflammatory agent. This study aimed to analyze how to balance between IL-10 and IL-5 levels on persistent atopic asthma. The study design was an experimental research method with invitro study used isolation and cell culture of Peripheral Blood Mononuclear Cell (PBMC) with negative control Roswell Park Memorial Institute (RPMI) medium, positive control Phytohaemaglutinin (PHA) and house dust mite allergen stimulation 10 µl. This study involved 39 samples asthmatic. There was a significant increase in IL-5 levels after stimulation of house dust mite allergens with p: 0.000; there was a significant decrease in IL-10 levels after house dust mite allergen stimulation with p: 0.000. Our study suggests that IL-5 and IL-10 balance is related to persistent atopic asthma after house dust mite allergen Der p stimulation. Keywords: Interleukin 5, Interleukin 10, Atopic Asthma, house dust mite allergen, ELIS

Comparison of Specific Immunoglobulin E with the Skin Prick Test in the Diagnosis of House Dust Mites and Cockroach Sensitization in Patients with Asthma and/or Allergic Rhinitis

Background: nowadays, specific IgE measurement has been conducted in Indonesia, however there is still lack of data regarding diagnostic test to detect inhalant allergen in patients with respiratory allergies.This study aimed to determine the accuracy of specific IgE test in diagnosing specific sensitization of inhalant allergen in patients with respiratory allergies. Methods: this was a cross sectional study in patients with respiratory allergies and part of epidemiology study regarding to specific IgE sensitization in Allergy-Immunollogy Division, Cipto Mangunkusumo Hospital, Jakarta within November-December 2016. Measurement of specific IgE sensitization using Immunoblot method (Euroline®, Euroimmun AG, Germany). The tested allergen is house dust mites [Dermatophagoides pteronyssinus (Der p), Dermatophagoides farinae (Der f), Blomia tropicalis (Blo t)] and cockroach  [Blatella germanica (Bla g)]. The result is compared with gold standard, skin prick test. The diagnostic result includes sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-). Results: a total of 101 patients were enrolled; 77 (76.2%) were women. Patients mean age was 38.8 years old. Based on SPT, sensitization was highest for Blo t (76.2%), followed by Der p (70.3%), Der f (69.3%), and Bla g (41.6%). Specific IgE-sensitization was highest for Der f (52.9%), followed by Der p (38.2%), Blo t (33.3%) and Bla g (10.8%). Der p allergen had 50.7% sentivity, 90% specificity, 92.3% PPV, 43.5% NPV, 5.1 LR+ and 0.1LR-. Der f showed 71.4% sensitivity, 87.1% specificity, 82.6% PPV, 57.4% NPV, 5.5 LR+ and 0.3 LR-. Blo t allergen had 41.6% sensitivity, 91.7% specificity, 94.1% PPV, 32.8% NPV, 5.0 LR+, and 0.6 LR-. Bla g allergen had 23.8% sensitivity, 98.3% specificity, 90.9% PPV, 64.4% NPV, 14.5 LR+ and 0.8 LR-. Conclusion: serum specific IgE testing to common inhalant allergen in patients with respiratory allergy showed only low-to-moderate sensitivity, but high specificity and PPV. This new assay can be used to diagnose allergen sensitization in the population with high prevalence of TDR and cockroach

Approach to Diagnosis and Treatment of Drug Allergy

Drug allergy is a serious medical problem. Drug allergy can be defined as an adverse drug reaction involving immunological mechanism. However, it is not easy to decide whether an adverse drug reaction is an allergic reaction, and it requires a systematically diagnostic approach. Beside a thorough history taking and physical examination, there are general and specific laboratory examination to investigate drug allergy which can be done in vivo, in vitro, or biopsy. The management of drug allergy include the avoidance of the precipitating event, and specific methods to reduce the drug reaction which include threating through, dosing test, desensitization, and the administration of premedication for certain drugs

The Differences in Serum Quantitative Specific IgE Levels Induced by Dermatophagoides pteronyssinus, Dermatophagoides farinae and Blomia tropicalis Sensitization in Intermittent and Persistent Allergic Asthma

Background: house dust mites (HDM) are an important inhalant allergen in allergic asthma. However, molecular diagnostic study of specific IgE to HDM allergens has not been done in Indonesia. In addition, the association of quantitative specific IgE measurement with asthma severity has not been investigatedd. This study aimed to investigate the difference of serum quantitative specific IgE levels induced by Dermatophagoides (D.) pteronyssinus, D. farinae and Blomia tropicalis sensitization in intermittent and persistent allergic asthma.Methods: this was a cross-sectional study on adult allergic asthma patients who were invited for serum specific IgE testing. This study was a part of a larger study within the Division of Allergy and Immunology, Cipto Mangunkusumo Hospital. Asthma severity was defined based on Global Initiative on Asthma (GINA) 2015 criteria and were grouped as intermittent or persistent. Quantitative specific IgE testing was done on blood serum using a multiple allergosorbent test (Polycheck Allergy, Biocheck GmbH, Munster, Germany). The HDM allergens tested were D. pteronyssinus, D. farinae, and Blomia tropicalis. Difference between two groups were analyze using Mann-Whitney test.Results: a total of 87 subjects were enrolled in this study; 69 (79.3%) were women. Mean patients’ age was 40, 2 years. Sixty-three (72.4%) subjects had asthma and allergic rhinitis. Fifty-eight (66.7%) subjects were classified as persistent asthma. The prevalence of sensitization was 62.1% for D. farinae, 51.7% for D. pteronyssinus, and 48.3% for Blomia tropicalis. The median of specific IgE levels were significantly higher in persistent asthma compares to intermittent asthma induced by D. farinae (median 1.30 vs. 0.0 kU/L; p=0.024) and B. tropicalis (median 0.57 vs. 0.0 kU/L; p=0.015) sensitization. Level of Specific IgE  D. pteronyssinus was also to be higher in persistent asthma than the level measured in intermittent asthma (0.67 vs. 0.00 kU/L; p=0.066).Conclusion: Sensitization of HDM allergens was shown to be highest for D. farinae 62.1%, followed by D. pteronyssinus 51.7% and Blomia tropicalis 48.3%. Specific IgE level induced by D. farinae and Blomia tropicalis sensitization were significantly higher in patients with persistent asthma compared to intermittent asthma, whereas specific IgE level induced by D. pteronyssinus sensitization was higher in persistent asthma although not statistically significant

Faktor Pencetus Kejadian Alergi Pernapasan Pada Pasien Dewasa Di RSUPN Dr. Cipto Mangunkusumo: The Triggering Factors of Respiratory Allergiesin Adult Patients at the RSUPN Dr. Cipto Mangunkusumo

Allergy is a hypersensitive reaction in human due to human body produced IgE antibody more than regullary do as a response to the presence of allergens. Asthma and rhinitis are respiratory allergies, could be caused by genetics and environmental factors. The objectives of this study was to analyze the trigger factors of asthma and rhinitis patients at the Allergy-Immunology Polyclinic, Internal Medicine Department, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo National Center General Hospital, Jakarta. The skin test using grass mix pollen, cat, dog, cockroach, and dust mites allergens were done to 90 respiratory allergy patients. History of respiratory allergy from their parents, and environmental factors such as pets, cigarette smoke, and emotional state were asked and recorded. The patients mostly women, and most respiratory allergy patients could be detected by skin test using dust mites allergens, however, their reaction did not the same for other allergens. More than 50% patients of respiratory allergy have atopy from their parents, for most of patients, their emotional state and cigarette smoke in house could trigger the symptom of respiratory allergy.&nbsp